Best route to PACU/Outpatient Work

Specialties PACU

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I am in nursing school and I'm looking for some advice. I have 4 small children and my husband is a firefighter. I know I want to be a nurse, but the scheduling aspect has been a big concern of mine - just with the potential of my husband and I BOTH having to work a holiday, etc. A friend who is a nurse mentioned various options in nursing with a more consistent schedule, one of them being a PACU nurse in an outpatient facility. I realize that I will likely make less money than in a hospital setting. I also understand that as a new nurse, I will have to take whatever I can get and pay my dues, but I am wondering where I can get the best experience for this type of job. Or if anyone has any advice in general about how to get into a position like this? Do they ever hire new nurses? I appreciate any feedback. Thank you so much!!!

Dakeirus

95 Posts

Specializes in ICU, PACU.

There are some hospital PACUs that are also closed on holidays/weekends. Finding it is the problem. There are PACUs that will hire new grads or floor nurses but it will be hard unless you know how to sell yourself or know someone. PACUs generally like hiring ICU or ER nurses because the transition is a lot easier. Depending on the facility, most of the time, the patients recover okay with no issues. But then there are patients who will obstruct, go into a laryngospasm or just really crash on you. And you need to know what to do. That is when critical care experience is really valuable in the PACU.

jj16, BSN

40 Posts

Thank you!!! This is helpful!

brownbook

3,413 Posts

Also there are a lot of out patient GI clinics with good hours. Many are part of ambulatory surgery clinics or you may be able to transition from a GI clinic to a ambulatory surgery clinic.

EP lab/Endoscopy lab/outpatient surgery/interventional radiology all sound like they could work for your schedule.

Collor

66 Posts

Also consider day surgery in the hospital. Our hospital day surgery unit is Mon-Fri. No weekends, no holidays, no on-call.

ruby_jane, BSN, RN

3,142 Posts

Specializes in ICU/community health/school nursing.

Please understand that you really need a year in an acute care setting (especially if you want PACU). You will hurt your career in the long run without some acute care experience - even if you know you never want to be a hospital nurse, never say never. Having said that, do all that you can now to ensure that this will be possible for you when you graduate. Is it possible the hubby can get a different job?

I agree that a good idea is to get a good base of acute care experience before moving into a PACU position. I went straight into PACU and to some degree have struggled to get out of it. Lots of positions that are in that realm of pain management and patient recovery, but you may someday wish you could try something different and will be struggling to move out. My path has brought me through 3 different PreOp/PACUs until my current job as a Pain RN and care manager for patients planning surgery. Even with my newly minted FNP, I have employers begging me to go into a pain management role over primary care.

That being said, you can start in periop areas as a new grad with the right background. The path I chose was to ensure I got some good critical care experience during school. There was a summer program that hired us to work in various areas of the hospital as SNAs (student nurse associates) which got me a wealth of knowledge of everything from patient monitoring to IV pain medication administration. While this wasn't the be-all end-all, it was a good foundation that gave my first employer some comfort hiring me out the gate. Also at placed like Detroit Medical Center, we had SNAs work directly in our PACU doing jobs of POAs while also learning the ins and outs of our jobs. Many of these SNAs were hired upon graduation. Any chance you can get to volunteer or work inside that setting will be to your benefit.

HeySis, BSN, RN

435 Posts

Specializes in PACU.

MY PACU hours are the most inconsistent hours I have ever worked in 25 years of nursing. Suppose to come in at 7 and then the first surgeries are all long ones so get pushed back to 8. Suppose to go home at 4:30 but there are bunch of add ons that has kept rooms open and running longer, don't expect to leave.

On call at least once a week in our PACU. You may not get all call the entire time (calls are 12h during the week and 24 on the weekend/holiday) or you maybe at work for 24 hours straight. We also maybe scheduled the day of and day after a 12 hour call shift...... When someones on vacation I work 5 days a week and still take at least on call, which means its a night I've already worked a full day and have to be back the next day or I take a 24 on one of the weekends and work 6 days that week.

Now I don't mind this schedule, in fact I love call because it helps make up cut hours. (learn about how many cut hours and how cuts are decided), but many people leave PACU, not because of the work, but because of the schedule.

And we are super busy during the winter holidays, everyone is trying to get surgeries in before their deductible resets... so November and December, it's hard to get time off or get out on time. But come January and you could be using PTO to fill out your hours if you need the consistent paycheck, because all the Ors are done by 2 on the afternoon and everyone goes home... no patients = no hours. They just don't teach about cut hours in nursing school.

EDIT: I re-read and it seems you are talking about an out-pt center. You would probably not have call or have to work holidays... they too have longer hours during certain times of year and called off/cut hours at others.

MY PACU hours are the most inconsistent hours I have ever worked in 25 years of nursing. Suppose to come in at 7 and then the first surgeries are all long ones so get pushed back to 8. Suppose to go home at 4:30 but there are bunch of add ons that has kept rooms open and running longer, don't expect to leave.

On call at least once a week in our PACU. You may not get all call the entire time (calls are 12h during the week and 24 on the weekend/holiday) or you maybe at work for 24 hours straight. We also maybe scheduled the day of and day after a 12 hour call shift...... When someones on vacation I work 5 days a week and still take at least on call, which means its a night I've already worked a full day and have to be back the next day or I take a 24 on one of the weekends and work 6 days that week.

Now I don't mind this schedule, in fact I love call because it helps make up cut hours. (learn about how many cut hours and how cuts are decided), but many people leave PACU, not because of the work, but because of the schedule.

And we are super busy during the winter holidays, everyone is trying to get surgeries in before their deductible resets... so November and December, it's hard to get time off or get out on time. But come January and you could be using PTO to fill out your hours if you need the consistent paycheck, because all the Ors are done by 2 on the afternoon and everyone goes home... no patients = no hours. They just don't teach about cut hours in nursing school.

EDIT: I re-read and it seems you are talking about an out-pt center. You would probably not have call or have to work holidays... they too have longer hours during certain times of year and called off/cut hours at others.

Good point in cut hours. I always forget about how seasonal the job is and how certain times of year tile more likely to be low censused.

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